Cochlear fossa enhancement at MR evaluation of vestibular Schwannoma: correlation with success at hearing-preservation surgery.

Objective: To describe a sign in magnetic resonance (MR) imaging that could reflect the state of the cochlear nerve before hearing-preservation surgery in small vestibular schwannomas.

Methods: Thirty-one patients with serviceable hearing underwent 1.5-T MR imaging before hearing-preservation surgery. The presence of cochlear fossa enhancement on T1-weighted spin-echo images obtained after the administration of contrast material was compared with the results of hearing-preservation surgery.

Results: Cochlear fossa enhancement was present in 13 patients, and all of them had total hearing loss after surgery. There was no cochlear fossa enhancement in 18 patients; 15 maintained serviceable hearing after surgery, and three had postoperative hearing loss with no serviceable hearing (sensitivity, 81%; specificity, 100%).

Conclusions: Cochlear fossa enhancement on T1-weighted spin-echo images seems to be a reliable sign for analyzing the state of the cochlear nerve. The absence of cochlear fossa enhancement could become an additional criterion for selecting the surgical approach in vestibular schwannomas.